Primaxin I.V.

SIDE EFFECTS

Adults

PRIMAXIN I.V. is generally well tolerated. Many of the
1,723 patients treated in clinical trials were severely ill and had multiple
background diseases and physiological impairments, making it difficult to
determine causal relationship of adverse experiences to therapy with PRIMAXIN
I.V.

Local Adverse Reactions

Adverse local clinical reactions that were reported as
possibly, probably, or definitely related to therapy with PRIMAXIN I.V. were:

DRUG INTERACTIONS

Generalized seizures have been reported in patients who
received ganciclovir and PRIMAXIN. These drugs should not be used concomitantly
unless the potential benefits outweigh the risks.

Since concomitant administration of PRIMAXIN and
probenecid results in only minimal increases in plasma levels of imipenem and
plasma half-life, it is not recommended that probenecid be given with PRIMAXIN.

PRIMAXIN should not be mixed with or physically added to
other antibiotics. However, PRIMAXIN may be administered concomitantly with
other antibiotics, such as aminoglycosides.

Case reports in the literature have shown that
co-administration of carbapenems, including imipenem, to patients receiving
valproic acid or divalproex sodium results in a reduction in valproic acid
concentrations. The valproic acid concentrations may drop below the therapeutic
range as a result of this interaction, therefore increasing the risk of
breakthrough seizures. Although the mechanism of this interaction is unknown,
data from in vitro and animal studies suggest that carbapenems may inhibit the
hydrolysis of valproic acid's glucuronide metabolite (VPA-g) back to valproic
acid, thus decreasing the serum concentrations of valproic acid (see WARNINGS,
Seizure Potential).